New metabolite-based diagnostic test could help detect pancreatic cancer early

A new diagnostic test that uses the technique of metabolomic analysis may be a safe and easy screening method that could improve the prognosis of patients with pancreatic cancer through earlier detection. In a new study, researchers examined the utility of metabolomic analysis as a diagnostic method for pancreatic cancer and then validated the new approach.

"Although surgical resection can be a curative treatment for pancreatic cancer, more than 80% of patients with pancreatic cancer have a locally advanced or metastatic tumor that is unresectable at the time of detection," said Masaru Yoshida, MD, PhD, associate professor and chief of the Division of Metabolomics Research at Kobe University Graduate School of Medicine in Kobe, Japan. "Conventional examinations using blood, imaging, and endoscopy are not appropriate for pancreatic cancer screening and early detection, so a novel screening and diagnostic method for pancreatic cancer is urgently required."

Using gas chromatography mass spectrometry, the researchers measured the levels of metabolites in the blood of patients with pancreatic cancer, patients with chronic pancreatitis, and healthy volunteers. Forty-three patients with pancreatic cancer and 42 healthy volunteers were assigned to a training set, and 42 patients with pancreatic cancer and 41 healthy volunteers were assigned to a validation set. All the patients with chronic pancreatitis (23) were in the validation set.

Analysis of the metabolomic data generated from the training set indicated that levels of 18 metabolites were significantly different in the blood of patients with pancreatic cancer compared with the healthy volunteers. Further investigation led the researchers to develop a method to predict a pancreatic cancer diagnosis using assessment of the levels of just four metabolites. In the training set, the approach demonstrated 86% sensitivity and 88.1% specificity. When tested again in the validation set, the method demonstrated 71.4% sensitivity and 78.1% specificity. The study results were published in Cancer Epidemiology, Biomarkers & Prevention (2013; doi: 10.1158/1055-9965.EPI-12-1033).

"Our diagnostic approach using serum metabolomics possessed higher accuracy than conventional tumor markers, especially at detecting the patients with pancreatic cancer in the cohort that included the patients with chronic pancreatitis," Yoshida said. "This novel diagnostic approach, which is safe and easy to apply as a screening method, is expected to improve the prognosis of patients with pancreatic cancer by detecting their cancers early, when still in a resectable and curable state."